Health Committee on Feb. 1st, 2024

[Jenica Atwin, Liberal, Fredericton, NB]

Thank you.

I just have a couple of seconds left, I'm sure, but I'd like to give a shout-out to my home community and to the recovery centre and all the work that they do. I have the good fortune of attending Snacktivist Fridays and hanging out with those folks with that lived experience and learning about how this is improving their lives. They're getting hold of their mental health and seeking meaningful employment and housing options. That continuum of care is certainly an approach that's working in my community.

Thank you so much.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Atwin.

Ms. Larouche, you have the floor for six minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Mr. Chair.

This issue is far too serious to be politicized. I will try to work hard here today, as the member for Montcalm usually does, a colleague I am honoured to replace at this committee.

I am here today with a great deal of sensitivity and interest. As a teenager, I remember meeting a group working for drug harm reduction, which did so from a public health perspective.

I am an MP in a region that includes the city of Granby. We see that the crisis has spread beyond large urban centres. I recently heard it's even started happening in the community of Granby and that people died as a result. The crisis is actually lowering life expectancy in Canada.

Minister, I'd like to come back to the regional perspective on the situation. Is the government planning to invest anything so that new communities can access existing programs? Let me explain.

Recently, my colleague Luc Thériault went to meet stakeholders working in a centre located in a much more remote region than mine. They explained that people had to travel for two or three hours to access services, and there was no money to bring the services closer to them.

What are you planning to do to help people on the ground, not just in large centres, but also outside those areas, and even in the more remote regions?

[Ya'ara Saks, Liberal, York Centre, ON]

I thank my colleague for her question.

It's an excellent question and one that we really do grapple with. One of the important pieces of the SUAP program, on which we just closed a recent funding cycle of proposals, is that we received 600 proposals from around the country for allocating $144 million. They were accepted from communities far and wide, from throughout the country. Quebec is unique in its tranche of SUAP funding, which is transferred to the province for its own decisions under its jurisdiction.

That said, through SUAP we have looked at programs such as the NORS overdose call hotline, which makes it accessible for anyone using substances to call from wherever they are in the country so that they can be monitored safely while using them. We will continue to work with communities, including rural and remote communities, as they offer proposals to us for consideration to help that support.

Communities know what they need best, and we will continue looking through that lens.

[Andréanne Larouche, Bloc, Shefford, QC]

I see. You said it well: Quebec is unique. I'll come back to it later, but there is indeed work being done on mental health. To continue implementing its projects, Quebec is asking for an increase in health transfers. I hope you will raise this consideration with your colleagues who have a health-related department.

In the past, I worked at the community level for an organization involved in alternative justice and mediation, which led me to consult with other community groups. I soon heard about a similar initiative involving prevention and education.

I met with an organization that raised awareness and worked in large events. I'd like you to explain something to me. Health Canada wanted to communicate with more than 2,000 festival organizers to provide information on naloxone and promote the distribution of overdose prevention kits among event participants and staff.

Where are you in this process? What was the response from event organizers?

[Ya'ara Saks, Liberal, York Centre, ON]

I want to thank my colleague for the question.

I will acknowledge that Quebec does have some incredible innovations. My counterpart, Minister Carmant, has shared with me the work being done in Saint-Henri on a very innovative project there that has full wraparound services, including a safe consumption site.

You raise a very important point of how valuable the work is that we do with outreach organizations in communities. I was recently in Calgary and met with workers there who do exactly that. They are in touch with festival organizers, rave organizers and other cultural events to ensure that there's a wide range of harm reduction resources available to participants, ranging from condoms to harm reduction tools that they would need, including drug-checking strips and so on and so forth.

This is work that we, through SUAP, are able to support and fund. Our very dedicated and committed and compassionate outreach workers around this country who work in communities really understand where they need to meet those who are using drugs—where they're at—so that they can provide that first entry point for creating safety and also provide upstream prevention and education.

SUAP is an amazing tool that we continue to support and use. I'm excited to see the new round of proposals and programs as they roll out this year.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Larouche.

Next we'll have Mr. Johns, please, for six minutes.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Thank you, Mr. Chair.

Thank you, Minister, for being here, and especially to your team and all of the people on the front lines of this crisis.

Minister, you read the article, I'm sure, in the Globe and Mail. It was a new research report that was released to the public and it cited that British Columbians who were at risk of death related to illicit opioid use were 61% less likely to die from any cause in the following week if prescribed at least one day's supply of a pharmaceutical alternative.

This research also stated that if they received four or more days of safer supply in one week, the rate of any cause of death was lowered by 91% in the next week and death from overdose was reduced by 89%.

In British Columbia, there are 4,265 people on a safer supply pharmaceutical drug alternative. That's only 1.8% of the 225,000 daily users of illicit substances and toxic drugs; the other 98.2% are relying on the organized crime and street toxic drug supply to meet their needs.

Minister, the scientific evidence demonstrates that the life-saving impacts of safer supply clearly are critical. I'm concerned that your policies have not been created based on evidence, because if you went on the evidence, you wouldn't take an incremental approach: You'd be scaling things up.

I'm concerned about the fearmongering that's coming from Conservatives and also the hesitancy to extend funding for the 21 safer supply programs that are providing effective care right now to thousands of people. My understanding is that cutting the funding to these programs is dooming about 30% of federally funded safer supply program clients to their death within six months of ending those programs.

Minister, what will you say to those families in six months if SUAP funding for safer supply programs is not renewed?

[Ya'ara Saks, Liberal, York Centre, ON]

I want to thank my colleague for the question.

I always appreciate that you are such a strong advocate not only for your community but also in tackling collaboratively the overdose crisis and the illicit toxic drug supply that is impacting so many of our families and communities.

There are 24 safer supply programs in the SUAP at this moment in time, as I mentioned in my earlier comments. Officials have been doing extensive reviews to ensure that diversion mitigation measures are in place.

The new funding round of proposals has been accepted and is under review, and announcements will be coming soon for the programs. For those who applied for renewed support, it will be available. They will be considered under that proposal program.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Minister, these peoples' lives are at risk. This is real.

Minister, I want to state a few things here. We're hearing the conversation here at this table that it shouldn't be about recovery versus harm reduction. There are mountains of evidence on the effectiveness of harm reduction programs like supervised consumption services and now safer supply. Will the Liberal government create policies based on evidence or will they do it in reaction to the fearmongering that's coming from this side?

Let's look at the evidence of what happens when fearmongering shuts down harm reduction programs. I'm going to go back to the Conservatives. It shouldn't be recovery versus harm reduction. We need both.

In Alberta, the banning of safer supply, closure of supervised consumption services and adoption of a recovery model that lacks evidence and regulation have led to an 18% increase in drug toxicity deaths this year over 2022. In Saskatchewan, where harm reduction has been abandoned in favour of a recovery model, deaths in 2023 increased by 32% over 2022. Saskatchewan also has the highest rate of HIV in Canada, with 19 per 100,000.

In Ontario and B.C., where there are relatively robust harm reduction programs, deaths are also increasing due to the unregulated fentanyl supply, but at significantly lower rates. In B.C., deaths are up by 5%. In Ontario, it's 6.8%. Again, that's compared to 18% in Alberta and 32% in Saskatchewan.

Any increase in deaths is not acceptable to anyone at this table. It's a policy failure and it's morally reprehensible. The Conservative anti-harm reduction and anti-safe supply disinformation campaign is most active in the provinces with the highest death rates.

Minister, the data is clear, yet your government is stalling on providing SUAP funding for safer supply programs.

Are your government policies on this issue based on evidence or on opinion polling that is influenced by the false narrative of the Conservatives?

[Ya'ara Saks, Liberal, York Centre, ON]

Chair, how much time do I have to answer?

[The Chair, Liberal, Sean Casey]

You have a minute and 15 seconds.

[Ya'ara Saks, Liberal, York Centre, ON]

I agree with my colleague wholeheartedly. In addressing the overdose crisis, there is no either-or: It's not either harm reduction or treatment; it's not either safer supply or recovery.

As I've said, and I will repeat, we need a full continuum of care. health care interventions and services to help those who are most vulnerable and struggling with substance use.

With regard to your question, Mr. Johns, we've contacted all of our programs on safer supply that are expiring. It is my full intention to have our department review and renew those programs with proper mitigation measures in place with regard to concerns that have been raised on diversion.

We are collecting data and evidence through CRISM. That is exactly why SUAP exists. It's so that we have evidence to show if these measures are working. We know that those who are in safer supply programs begin a process of stabilization. They begin to make better health choices for themselves. It reduces criminal activity. It reduces someone going on the street to look for alternatives, to pay for illicit drugs that can cause them harm.

We have to meet people where they are at in the moment when they reach out for help. That is why safer supply is such an important piece of the puzzle when we go to save lives. We cannot do an either-or. We cannot stigmatize people when they actually step up and ask for help. We can't turn them away, saying that it's either this or nothing. They will die of an overdose if we do not meet them where they are at.

I say, as the Minister of Mental Health and Addictions, that my sole focus is to save lives.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Mrs. Goodridge, please go ahead for five minutes.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Thank you, Mr. Chair.

Minister, you're a mom. I'm a mom. Recently in B.C., protocols have been put in place to allow so-called safe supply of fentanyl to kids under 18 without parental consent or knowledge.

My question is simple. Have you met with the Prime Minister to put a stop to this?

[Ya'ara Saks, Liberal, York Centre, ON]

I think the more important question is to meet with the experts who are involved in the prescriber intervention models that you discussed. They are truly the experts in this field. That is something that we have done.

Like yourself, I am a mother—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Minister, have you met with the Prime Minister, yes or no?

[Ya'ara Saks, Liberal, York Centre, ON]

I meet with the Prime Minister regularly.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Have you met up with the Prime Minister to discuss fentanyl for children under 18 and putting an end to it, yes or no?

[Ya'ara Saks, Liberal, York Centre, ON]

The question that should be asked is on meeting with experts and physicians who are responsible for prescriber models for their patients. Medical practitioners and—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Are you okay with children under 18 getting fentanyl prescribed?

[Ya'ara Saks, Liberal, York Centre, ON]

The question was whether or not I met with the Prime Minister. That was not.... The question was not whether or not—

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Okay. Are you okay with children under 18 being prescribed fentanyl? Answer yes or no.

[Ya'ara Saks, Liberal, York Centre, ON]

I am comfortable with medical practitioners meeting with their patients to understand what is best for their patients.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

On September 26, in question period, you said decriminalization was the first step. What's the second step?